Resilience and psychosocial factors linked to symptom experience during the menopause transition for women living with HIV.
Journal
Menopause (New York, N.Y.)
ISSN: 1530-0374
Titre abrégé: Menopause
Pays: United States
ID NLM: 9433353
Informations de publication
Date de publication:
14 01 2022
14 01 2022
Historique:
received:
21
07
2021
accepted:
12
10
2021
entrez:
31
3
2022
pubmed:
1
4
2022
medline:
5
4
2022
Statut:
epublish
Résumé
Women living with HIV (WLWH) are commonly symptomatic during perimenopause and menopause (≥1 y without menstruation), however, little is known of risks for symptoms and their timing. We analyzed these unwanted experiences to inform care. WLWH (≥40 y) in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study rated midlife experiences for seven symptoms and a symptom composite (from 0 to 21). Timing was categorized into four phases: i) perimenopause (flow in the last year), ii) 1-2 years from final menstrual period (FMP), iii) 2-5 years post-FMP; and iv) >5 years post-FMP. Resilience (standardized out of 100) was assessed based on Wagnild's Resilience Scale. Univariable/multivariable mixed effects linear regression assessed correlates of symptom intensity by composite score. Among 457 peri-/menopausal women mean age 54.7 (±6.6) over two time points (703 observations), 88% experienced ≥1 mild symptom; 75% were of moderate and 55% severe intensity. The most frequently reported symptoms were joint/muscle stiffness (67%), depressed mood (67%), and hot flashes (57%). After adjusting for reproductive phase, we found that women with greater resilience had fewer/lower intensity symptoms (symptom score 1.37 [2.30 to 0.44] lower; P = 0.004); those with depressive symptoms and recreational drug use (respectively) had more/higher intensity symptoms (scores 1.71 [0.61 to 2.82] [P = 0.002]; 2.89 [2.09 to 3.77] [P<0.001] higher). Symptoms were most intense in perimenopause and declined with increasing menopausal years (P = 0.03). WLWH experiences a high burden of midlife symptoms, decreased by resilience and most intense during perimenopause. Unwanted experiences were linked to psychosocial and behavioral factors. These data encourage HIV providers to adopt a bio-psychosocial approach to midlife management.
Identifiants
pubmed: 35357366
doi: 10.1097/GME.0000000000001926
pii: 00042192-202204000-00009
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
430-439Subventions
Organisme : CIHR
Pays : Canada
Informations de copyright
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The North American Menopause Society.
Déclaration de conflit d'intérêts
Funding/support: This work is supported by funding from the Michael Smith Foundation of Health research, CIHR Women’s Health and Mentorship Grant, CIHR Canadian Trials Network and UBC Clinician Investigator Program. CHIWOS is funded by the Canadian Institutes of Health Research (CIHR), the CIHR Canadian HIV Trials Network (CTN 262), the Ontario HIV Treatment Network (OHTN), and the Academic Health Science Centres (AHSC) Alternative Funding Plans (AFP) Innovation Fund. AK received salary support through a Tier 2 Canada Research Chair in Global HIV and Sexual and Reproductive Health. Financial disclosure/conflicts of interest: Dr. Murray receives funding from Merck, Gilead, and GSK/Viiv. The other authors have nothing to disclose. Author contributions: Report conception (EMK, AK, JP, ML, MM), data collection (RG, ML, AK, AdP, PF, RA-N, GK), data cleaning and analysis (EMK, RG, AA), drafting manuscript (EMK, JP, ML, MM), and revision of manuscript (EMK, AK, JP, AA, PF, RA-N, GK, RG, AdP, ML, MM). All authors approved the submitted manuscript version and have agreed to be personally accountable for any questions related to accuracy or integrity of any part of the work.
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